State’s rural hospitals on life support

Tuesday, Feb. 16, 1999 | 11:47 a.m.

Too many rural hospitals in Nevada are hemorrhaging financially. Unless some of them get an infusion of money, or a relaxation in federal guidelines that threaten to strangle them, their failures could result in life-threatening situations for these small-town residents.

As the Sun's Martin Kuz reported Sunday, Nye Regional Medical Center in Tonopah is just one of the state's 10 rural hospitals that are losing money. Six of the rural hospitals had deficits last year, with the Tonopah hospital's deficit of more than $700,000 earning it the dubious distinction as the largest.

Simple geography shows how telling -- and perilous -- Tonopah's condition is: The Nye Regional Medical Center is the only hospital on Highway 95 between Las Vegas and Hawthorne, a distance of more than 300 miles. For those who have traumatic injuries or serious illnesses, the lack of a nearby facility can be the difference between life and death.

No one is suggesting that hospitals be kept open if there is no remaining population around. But in some cases if a hospital is allowed to wither and die, its demise may only contribute to the town's collapse since businesses and residents may be reluctant to live in an area where the nearest hospital is a two-hour drive away.

There are a number of reasons why rural hospitals are struggling: high costs of insurance and medical equipment, smaller populations, the trouble finding and keeping doctors, and a reduction in how much Medicare reimburses hospitals for services. There is only so much a rural hospital can do to combat these factors but, as Kuz noted, there are at least two options under consideration that will help.

State legislation proposed by Assemblyman Roy Neighbors, D-Tonopah, would allow a hospital district to keep collecting taxes to pay off its operating debt. This could act as an incentive for Nye County to continue subsidizing the hospital there, so if the hospital closed the county could still get its money back.

Another problem is that regulations require that for hospitals to maintain full-time status they must keep doctors and nurses on-duty 24 hours a day, even if there isn't a need. But Nevada has applied to participate in a federal program that allows rural hospitals to staff emergency rooms with mid-level practitioners and nurses. Even if Tonopah's hospital receives a waiver from the federal government to join the program, it may not happen until September, which means that $1.5 million in public funding may be needed to keep the hospital running.

Rural medicine in general has fallen on hard times in Nevada -- and the rest of the West -- as residents and doctors leave for urban areas. But local, state and federal governments should continue looking for innovative ways to keep these hospitals alive. Failure to do so will result in an appalling lack of medical care and an acceleration in the decline of these small towns.